Welcome to CANVax in Brief

The Canadian Vaccination Evidence Resource and Exchange Centre (CANVax) is an online database of resources to support immunization program planning and promotional activities to improve vaccine acceptance and uptake in Canada. CANVax aims to make it easier for public health professionals to find and collect resources by increasing access to information relevant to the Canadian context. CANVax is the first online database of its kind in Canada to equip public health professionals with access to a centralized resource centre focused on vaccine acceptance and uptake. 

The creation of CANVax is important, now more than ever, as we see growing challenges and serious consequences of the delay and refusal of vaccines. 

Take for example, adult immunization coverage. In Canada, the National Immunization Coverage Survey provides national estimates of vaccine coverage for select adult immunizations, and the data is disappointing to say the least. According to the most recent national survey (2014), pneumococcal vaccine coverage was estimated to be 37% for adults 65 years of age and older while influenza vaccine coverage was estimated to be only 40% among adults aged 18 years and older. Both coverage rates are well below national targets of achieving 80% coverage (Government of Canada, 2016). Although no national targets exist for tetanus and pertussis, coverage rates are suboptimal at 50% and 9%, respectively (Government of Canada, 2016). 

Why are adults under-vaccinated? The decision to vaccinate is complex and influenced by a wide range of factors. The “3 C’s” model proposed by the WHO EURO Vaccine Communications Working Group, describes 3 categories that can contribute to the delay and refusal of vaccination (Busby, 2018; MacDonald, 2015). They include:

• Confidence: refers to the trust in 1) vaccine safety and effectiveness, 2) the various systems that deliver vaccines such as health services and health professionals and 3) policy makers who make decisions about vaccines. 
• Convenience: is the ease or difficulty to receive immunizations. This includes both the quality of service, whether that is real or perceived and the delivery of the service that is most convenient and comfortable (i.e., time, place and cultural context).  
• Complacency: describes the perceived risk of acquiring the disease and can be influenced by a variety of factors such as other personal responsibilities that may be determined to be more important. 

(Busby, 2018; MacDonald, 2015)

What’s to be done? In the commentary by the C.D. Howe Institute, ‘Not Just for Kids: How to Improve Adult Vaccination Uptake in Canada’, the author recommends changes to the way in which the provinces and territories monitor and promote adult immunization uptake.  Suggestions include the development of a national vaccine list for adults to provide clarity on immunization schedules, making proof of adult immunizations a routine part of entry to post-secondary education, expanding the role of pharmacists in tackling complacency and convenience by setting up adult vaccine reminders and promotional interventions, and through the bundling of health care services (Busby, 2018).

Research has also shown that recommendations by health care providers are a strong predictor of vaccine uptake. As such, health care providers have an important role both in educating the public about vaccine preventable diseases and in recommending vaccines to promote uptake (Schneeberg et al, 2014; Skowronski et al, 2004).

Improving vaccine acceptance and uptake is both challenging and complex. CANVax aims to be the bridge that connects public health professionals to resources, tools and information to equip and inspire action towards improving vaccine coverage in Canada.  

Sincerely,

The CANVax Team
 

References:

Busby C. (2018). C.D Howe Institute Commentary – Not Just for Kids: How to Improve Adult Vaccination Uptake in Canada. Commentary No. 509. ISSN 1703-0765.

Government of Canada. (2016). Vaccine uptake in Canadian adults: results from the 2014 adult National Immunization Coverage Survey. Available from https://www.canada.ca/en/public-health/services/publications/healthy-living/vaccine-uptake-canadian-adults-results-2014-adult-national-immunization-coverage-survey.html [accessed 30.04.2018]

MacDonald NE. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine. 33:4161-4164. https://doi.org/10.1016/j.

Schneeberg A et al. (2014). Knowledge, attitudes, beliefs and behaviours of older adults about pneumococcal immunization, a Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) investigation. BMC Public Health. 14:442

Skowronski DM et al. (2004). Adult tetanus, diphtheria and pertussis immunization: knowledge, beliefs, behaviour and anticipated uptake. Vaccine. https://doi.org/10.1016/j.vaccine.2004.05.033